Here's What to Expect After Your COVID-19 Booster
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After first recommending that people in certain groups get a COVID-19 booster and then stating that people aged 18 and up may get a COVID-19 booster, the Centers for Disease Control and Prevention (CDC) is now strongly recommending that all people 16 and older get a COVID-19 booster. But what are the side effects of COVID-19 boosters?
On December 9, the CDC expanded its booster shot guidelines in light of the Omicron variant, advising all Americans at least 16 years old get a booster shot six months after their last dose of Pfizer or Moderna or two months after Johnson & Johnson. Adults can choose between any of the three available vaccines, while 16- and 17-year-olds can receive an additional Pfizer shot.
“Although we don’t have all the answers on the Omicron variant, initial data suggests that COVID-19 boosters help broaden and strengthen the protection against Omicron and other variants,” CDC director Rochelle Walensky, M.D. wrote in a statement announcing the new guidelines. “We know that COVID-19 vaccines are safe and effective, and I strongly encourage adolescents ages 16 and 17 to get their booster.”
If you’re planning to get a COVID-19 booster, you probably have some questions about how this will impact you and whether you’ll have any side effects. Here’s what you need to know.
Who should get a COVID-19 booster shot?
Updated guidance from the CDC says that everyone ages 16 and older who has completed their primary COVID-19 vaccination series should get a booster shot after a certain period of time has passed. The exact amount of time varies depending on the type of vaccine you received the first time around.
If you had a Pfizer-BioNTech or Moderna vaccine, the CDC recommended getting a booster dose after at least six months have passed since you received your second shot. If you received the Johnson & Johnson vaccine, you should get a booster when it’s been at least two months since you had your primary series.
As for which shot to get for your booster, the CDC says it’s up to you. Because mix-and-match boosters were approved by the CDC, can get a dose of your original vaccine or opt for a different one.
“Go get boosted,” Anthony Fauci, M.D., the nation’s leading infectious disease expert, said on MSNBC last month. “We are entering the winter season; the weather will be colder, people will be indoors, they’re circulating virus around. We’re seeing an uptick in some of the cases right now.”
OK, but why do I need a booster shot?
Data suggest that immunity starts to wane for COVID-19 vaccines after a certain period of time. And with the rise of Omicron, it’s a great time to get vaccinated: Preliminary laboratory studies by Pfizer, for example, show that a third dose of its vaccine offers 25 times more antibody protection against Omicron than two doses alone.
“The available data make very clear that protection against SARS-CoV-2 infection begins to decrease over time following the initial doses of vaccination, and in association with the dominance of the Delta variant, we are starting to see evidence of reduced protection against mild and moderate disease,” officials from the United States Department of Health and Human Services (including Dr. Walensky and Dr. Fauci) wrote in August.
“Based on our latest assessment, the current protection against severe disease, hospitalization, and death could diminish in the months ahead, especially among those who are at higher risk or were vaccinated during the earlier phases of the vaccination rollout,” the announcement said. “For that reason, we conclude that a booster shot will be needed to maximize vaccine-induced protection and prolong its durability.”
A study of public health data from Israel released in July estimated that the Pfizer shot was 39% effective at preventing people from COVID-19 infection in June and early July, compared with the 95% efficacy from January to early April. (It’s important to note, though, that the vaccine was still more than 90% effective in preventing severe COVID-19 in people in June and July.)
Data shared by the CDC also clearly show that the vaccine’s ability to prevent COVID-19 declines over time, with exact drops varying by age and types of vaccine people received. Data on booster shots, however, have shown that the additional dose can help prevent people from getting symptomatic COVID-19.
“There are still a lot of COVID-19 cases and getting vaccinated, along with wearing a mask and social distancing, decreases your risk of getting COVID-19,” says Richard Watkins, M.D., an infectious disease physician and professor of internal medicine at the Northeast Ohio Medical University.
What should you bring to your booster shot appointment?
The CDC recommends bringing your COVID-19 vaccination record card to your appointment so that your vaccine administrator can fill in the information about your booster dose. And, if you didn’t receive a card at your original appointments or you’ve lost it, the CDC suggests contacting the site where you received your first shot or your state health department to find out how you can get your card.
Otherwise, it’s a good idea to wear a mask to your appointment to lower the risk you’ll contract COVID-19 while you’re there, says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York. (Note: Some vaccination sites also require that you be masked up on the premises anyway.)
What are the potential side effects of the COVID-19 booster?
As a whole, experts suggest side effects of the booster shot will be “mild,” if you even experience them at all, Dr. Watkins says. “As a general rule, people feel similar to how they felt after they got their second shot,” Dr. Russo says. He also stresses that the side effects you experience—or don’t experience—don’t correlate with your immune response to the vaccine.
One CDC study that was published in September found that people had similar reactions to a third dose of the mRNA vaccine compared to what they had during their original vaccines series. Side effects generally included:
Pain at the injection site
Fatigue
Headache
“These initial findings indicate no unexpected patterns of adverse reactions after an additional dose of COVID-19 vaccine,” the study says, noting that most of the side effects were “mild or moderate.”
Also worth pointing out: Pfizer said in press release that side effects from its COVID-19 booster were “similar to or better than after dose two of the primary series.” Meaning, you shouldn’t have worse side effects than you had with your first two COVID-19 vaccines.
Data submitted by Moderna to the Food and Drug Administration (FDA) found that these were the most common side effects in people who received a booster dose:
Injection site pain
Fatigue
Headache
Muscle or joint pain
Chills
Swollen lymph nodes
Nausea
Vomiting
Fever
“Of note, swollen lymph nodes in the underarm were observed more frequently following the booster dose than after the primary two-dose series,” the FDA says online.
FDA data for the Johnson & Johnson vaccine show that these are the most common side effects from the company’s booster:
Injection site pain
Headache
Fatigue
Fever
Nausea
Injection site swelling
What should you do if you have side effects from the COVID-19 booster?
The good news is they don’t typically stick around long. “Symptoms usually resolve in a day,” Dr. Watkins says. If you’re dealing with flu-like symptoms or are generally uncomfortable, Dr. Russo recommends taking acetaminophen (Tylenol) for relief.
But, if you notice that you’ve developed symptoms like a cough, shortness of breath, or a loss of taste or smell, Dr. Russo recommends getting tested for COVID-19. While you can’t get COVID-19 from the vaccine, it’s possible that you were infected with the virus before your booster shot kicked in, he says.
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